Abstract 4140229: Hypertension Enhances the Impact of Lipoprotein (a) on Coronary Artery Calcification in Coronary Heart Disease Patients Undergoing Percutaneous Coronary Intervention

Introduction: Both lipoprotein (a) [Lp(a)] and hypertension have been identified as the independent risk factors for atherosclerotic cardiovascular diseases. Coronary artery calcification (CAC) is a highly specific marker of atherosclerosis. However, though the association of Lp(a) and CAC is controversial, the combined effect of hypertension and Lp(a) on CAC remains unclear. Objective: This study aimed to investigate the combined effect of hypertension and Lp(a) on CAC in coronary heart disease patients undergoing percutaneous coronary intervention (PCI). Methods: 10,724 consecutive patients undergoing PCI in 2013 were enrolled. High Lp(a) level was defined as Lp(a)≥30mg/dl. Patients were divided into low-degree CAC group and high-degree CAC group according to the coronary angiography results. (Figure 1) Results: A total of 9,781 patients (mean age, 58.24 ± 10.30; male, 76.8%) who had both Lp(a) and CAC results were finally enrolled for analysis. Multivariate logistic regression analysis (Figure 2) showed that compared with patients without hypertension and high Lp(a), those with only high Lp(a) but without hypertension was not associated with high-degree CAC, which was same as in those with only hypertension but without high Lp(a) (all P >0.05). However, patients with both hypertension and high Lp(a) had significantly higher risk of high-degree CAC (OR=1.180, 95% CI=1.007-1.382, P =0.041). Moreover, age, diabetes and prior coronary artery bypass grafting were relevant risk factors of high-degree CAC (all P <0.05). Conclusions: In this large-scale real-world study, we reported for the first time that patients with both hypertension and high Lp(a) had significantly higher risk of high-degree CAC. In the future, whether targeting on both hypertension and Lp(a) could delay the progression of atherosclerosis and CAC deserves further investigation.